A girl with chronic pyelonephritis and dehydration developed tetany on two occasions after receiving a hypertonic phosphate enema. Biochemical evaluation disclosed hypocalcemia, hypomagnesemia, and, on one occasion, hyperphosphatemia. The tetany responded to calcium and magnesium therapy. We discuss the relationship of hyperphosphatemia, presumably secondary to colonic phosphate absorption, to hypocalcemia and hypomagnesemia. Phosphatecontaining enemas probably should be used with caution in patients with chronic renal insufficiency.
Chesney RW, Haughton PB. Tetany Following PhosphateEnemas in Chronic Renal Disease. Am J Dis Child. 1974;127(4):584–586. doi:10.1001/archpedi.1974.02110230130023